Access to healthcare, HIV/STI testing, and preferred pre-exposure prophylaxis providers among men who have sex with men and men who engage in street-based sex work in the US.
PLoS One
; 9(11): e112425, 2014.
Article
en En
| MEDLINE
| ID: mdl-25386746
ABSTRACT
BACKGROUND:
Pre-exposure prophylaxis (PrEP) is a promising strategy for HIV prevention among men who have sex with men (MSM) and men who engage in sex work. But access will require routine HIV testing and contacts with healthcare providers. This study investigated men's healthcare and HIV testing experiences to inform PrEP implementation.METHODS:
We conducted 8 focus groups (nâ=â38) in 2012 and 56 in-depth qualitative interviews in 2013-14 with male sex workers (MSWs) (nâ=â31) and other MSM (nâ=â25) in Providence, RI. MSWs primarily met clients in street-based sex work venues. Facilitators asked participants about access to healthcare and HIV/STI testing, healthcare needs, and preferred PrEP providers.RESULTS:
MSWs primarily accessed care in emergency rooms (ERs), substance use clinics, correctional institutions, and walk-in clinics. Rates of HIV testing were high, but MSWs reported low access to other STI testing, low insurance coverage, and unmet healthcare needs including primary care, substance use treatment, and mental health services. MSM not engaging in sex work were more likely to report access to primary and specialist care. Rates of HIV testing among these MSM were slightly lower, but they reported more STI testing, more insurance coverage, and fewer unmet needs. Preferred PrEP providers for both groups included primary care physicians, infectious disease specialists, and psychiatrists. MSWs were also willing to access PrEP in substance use treatment and ER settings.CONCLUSIONS:
PrEP outreach efforts for MSWs and other MSM should engage diverse providers in many settings, including mental health and substance use treatment, ERs, needle exchanges, correctional institutions, and HIV testing centers. Access to PrEP will require financial assistance, but can build on existing healthcare contacts for both populations.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
10_ODS3_salud_sexual_reprodutiva
/
11_ODS3_cobertura_universal
/
1_ASSA2030
/
2_ODS3
Problema de salud:
10_family_planning
/
10_sexual_health_reproductive_rights
/
10_sexually_transmitted_infections
/
11_delivery_arrangements
/
11_financial_arrangements
/
1_financiamento_saude
/
2_cobertura_universal
/
2_enfermedades_transmissibles
/
2_salud_sexual_reprodutiva
Asunto principal:
Enfermedades de Transmisión Sexual
/
Infecciones por VIH
/
Trabajadores Sexuales
/
Profilaxis Pre-Exposición
/
Accesibilidad a los Servicios de Salud
Tipo de estudio:
Diagnostic_studies
/
Qualitative_research
Aspecto:
Determinantes_sociais_saude
Límite:
Adult
/
Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
PLoS One
Asunto de la revista:
CIENCIA
/
MEDICINA
Año:
2014
Tipo del documento:
Article
País de afiliación:
Estados Unidos